US_ACTIVE-152607658.1 04/02/2020
The Interim Final Rule -- Waiver of Direct Supervision Requirements
The
Interim Final Rule scheduled to be published on 4/6 modifies supervision rules for diagnostic x-
ray tests, diagnostic laboratory tests, and other diagnostic tests. CMS has done this for tests
performed in physician offices and IDTFs and in hospital outpatient settings.
On p. 58 of the IFR on regulatory flexibilities, CMS states:
For the reasons discussed above, on an interim basis for the duration of the PHE for the
COVID-19 pandemic, we are altering the definition of direct supervision at § 410.32(b)(3)(ii),
to state that necessary presence of the physician for direct supervision includes virtual
presence through audio/video real-time communications technology when use of such
technology is indicated to reduce exposure risks for the beneficiary or health care provider.
We are revising § 410.32(b)(3)(ii) to include, during a PHE, as defined in § 400.200 of this
chapter, the presence of the physician includes virtual presence through audio/video real-
time communications technology when use of such technology is indicated to reduce
exposure risks for the beneficiary or health care provider.
10. Section 410.32 is amended by revising paragraph (b)(3)(ii) to read as follows:
§ 410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests:
Conditions.
* * * * *
(b) * * *
(3) * * *
(ii) Direct supervision in the office setting means the physician must be present in the office suite
and immediately available to furnish assistance and direction throughout the performance of the
procedure. It does not mean that the physician must be present in the room when the procedure is
performed. During a PHE, as defined in § 400.200 of this chapter, the presence of the physician
includes virtual presence through audio/video real-time communications technology when use of
such technology is indicated to reduce exposure risks for the beneficiary or health care provider.
On p. 61 of the IFR on regulatory flexibilities, CMS states:
For all of the same reasons described above, we are adopting similar changes in the
regulations at § 410.28(e)(1) with respect to the supervision of diagnostic services furnished
directly or under arrangement in the hospital or in an on-campus or off-campus outpatient
department of the hospital, as defined in § 413.65.
9. Section 410.28 is amended by revising paragraph (e)(1) to read as follows:
§ 410.28 Hospital or CAH diagnostic services furnished to outpatients: Conditions.
* * * * *
(e) * * *